Monday, April 29, 2013

Who says medics can’t make good managers?

By Lukoye Atwoli

Sunday Nation 28 April 2013

Earlier this past week, the Kenya Medical Association (KMA) issued a statement indicating that they disagreed with the President’s choice of a banker to head the ministry of Health. Indeed the association went as far as suggesting that the President re-designates the nominee to a more relevant ministry, and appoint a health professional to run the Health ministry.

KMA’s statement elicited varied reactions, both positive and negative. The President himself dismissed the statement, indicating that he was interested in appointing managers to run the ministries. The assumption, of course, is that health professionals are either not trained or experienced in management, an assumption that is at total variance with the facts on the ground.

Perhaps it is important to examine the background of KMA’s reaction.Firstly, the Jubilee Coalition’s health manifesto was produced by a team headed by a KMA member who also happened to have held the position of secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU). Throughout the process, it was the understanding of the drafting team that a health worker would eventually be appointed to implement the manifesto.

Secondly, throughout the campaign, the Jubilee team assured Kenyans that each ministry would be headed by a professional with relevant experience in the field. It would be difficult for even the most adept contortionist to demonstrate how a banker would fit the bill as a professional in the health sector.

Some have argued that medics are too few to be wasted on management, and that they should therefore be confined to hospitals seeing patients. However, no one attempts to interrogate the reasons why there are so few medics in the public health sector.

Perennial mismanagement in the ministry has resulted in a situation whereby the numbers of some cadres of health workers have been reducing over time, despite the fact that our universities continue to churn out large numbers of these cadres every year.

Why has the ministry been so poor in retaining high quality human resources for health in sufficient numbers to address the health challenges facing this country? Why are our health indicators either stagnating or sliding backwards over time?

The question KMA was asking is this: Why have successive governments been reluctant to appoint a highly qualified health worker to head the ministry of Health? What evidence exists to show that doctors or other health workers cannot run a ministry? If anything, available evidence suggests that health institutions run by doctors perform better on their core functions than those run by non-medics.

The same research actually suggests that in any field, “insider” managers outperform management experts sourced from outside the field. Why is an impression being created that doctors or other health workers cannot make good managers?

The idea being propagated that health workers are against the nominee as an individual is completely off the mark. The association is very clear that the nominee is highly educated and experienced in his field. The only grouse is that he is probably not best suited to head a ministry that is so bedevilled by problems that it needs immediate measures to resuscitate it.

One would remain hopeful that the President will listen to professionals on this matter, and perhaps appoint relevant people to posts they are suited to hold.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine lukoye@gmail.com; Twitter @LukoyeAtwoli